CAJ | 학술논문

目的观察胶原蛋白海绵在腰椎管狭窄症术后减少引流量的作用。方法因腰椎管狭窄症行腰椎管扩大减压、椎间植骨融合术患者186例，按照随机数字表法将患者分为改进组和对照组。改进组96例患者术后硬膜后放置胶原蛋白海绵；对照组90例患者术后使用传统止血方法止血，未放置胶原蛋白海绵。术后均放置引流管。观察比较两组术后1、12、24h引流量，术前与术后48h血常规的变化，术中及术后48 h输血量及输血率等。结果与对照组比较，改进组术后1、12、24h引流量均明显减少[分别为(106.11±20.02) ml比(127.02±25.09) ml、(236.12±34.06) ml比(327.31±51.21) ml、(355.16±49.03) ml比(506.36±85.29)ml]，差异有统计学意义(P＜0.05)。改进组输血量为(176.27±21.37)ml，输血率为10.42％(10/96)，均较对照组[(445.94±24.56)ml、32.22％(29/90)]显著减少(P＜0.05)。改进组术后48 h红细胞计数为(2.96±0.45)×1012/L、血红蛋白为(106.75±7.30) g/L，均高于对照组[(2.35±0.57)×1012/L、(90.45±5.10) g/L](P＜ 0.05)。结论胶原蛋白海绵在腰椎管狭窄症术后应用能快速、有效、持久地止血及减少脑脊液渗漏，是减少术后引流量的有效、经济手段。
목적관찰효원단백해면재요추관협착증술후감소인류량적작용。방법인요추관협착증행요추관확대감압、추간식골융합술환자186례，안조수궤수자표법장환자분위개진조화대조조。개진조96례환자술후경막후방치효원단백해면；대조조90례환자술후사용전통지혈방법지혈，미방치효원단백해면。술후균방치인류관。관찰비교량조술후1、12、24h인류량，술전여술후48h혈상규적변화，술중급술후48 h수혈량급수혈솔등。결과여대조조비교，개진조술후1、12、24h인류량균명현감소[분별위(106.11±20.02) ml비(127.02±25.09) ml、(236.12±34.06) ml비(327.31±51.21) ml、(355.16±49.03) ml비(506.36±85.29)ml]，차이유통계학의의(P＜0.05)。개진조수혈량위(176.27±21.37)ml，수혈솔위10.42％(10/96)，균교대조조[(445.94±24.56)ml、32.22％(29/90)]현저감소(P＜0.05)。개진조술후48 h홍세포계수위(2.96±0.45)×1012/L、혈홍단백위(106.75±7.30) g/L，균고우대조조[(2.35±0.57)×1012/L、(90.45±5.10) g/L](P＜ 0.05)。결론효원단백해면재요추관협착증술후응용능쾌속、유효、지구지지혈급감소뇌척액삼루，시감소술후인류량적유효、경제수단。
Objective To observe the effectiveness of collagen sponge for reducing volume of drainage after surgery for lumbar spinal stenosis. Methods One hundred and eighty-six patients who suffered from lumbar spinal stenosis were divided into two groups by random digits table method. The test group (96 cases) used collagen sponge to cover dura mater before placing drainage tube,the control group (90 cases) was treated without collagen sponge. The volume of drainage at 1,12,24 h after surgery were observed, the blood routine test was carried out at before and 48 h after surgery and the volume and ratio of blood transfusion after surgery was also measured and compared between the two groups. Results The volume of drainage were significantly decreased in the test group compared with the control group at 1,12,24h after surgery [( 106.11 ± 20.02 ) ml vs. ( 127.02 ± 25.09) ml, (236.12 ± 34.06) ml vs. (327.31 ± 51.21 )ml, (355.16 ± 49.03 ) ml vs.( 506.36 ± 85.29 ) ml](P ＜ 0.05 ). The volume and the ratio of blood transfusion in the test group were ( 176.27 ± 21.37) ml and 10.42％(10/96) ,which were greatly lower than those in the control group [(445.94 ±24.56) ml and 32.22％ (29/90)](P ＜0.05). The number of RBC and the concentration of Hb were (2.96 ± 0.45 ) × 1012/L and ( 106.75 ± 7.30) g/L, differently in the test group at 48 h after surgery,which were increased significantly compared with the control group [(2.35 + 0.57) × 1012/Land (90.45 ± 5.10) g/L](P ＜ 0.05 ). Conclusions Collagen sponge provides rapid ,effective and durable hemostasis and decreases the leak of cerebrospinal fluid after surgery for lumbar spinal stenosis. It can be used as an effective and economic method to reduce the volume of drainage after surgery.